The Mechanosensitivity of the Regenerative Response in Bone is Retained with Aging in a Mouse Model of Premature Aging.

Aging impairs the regenerative capacity of bone and is associated with poor healing outcomes. The mechanical environment is of fundamental importance to the regenerative response in bone - yet the effect of aging on the mechano-responsive capacity of bone regeneration remains largely unresolved. To investigate age-dependent mechanobiological responses in bone regeneration, we established an experimental framework consisting of: (i) an established femur defect mouse model, (ii) the use of PolgAD257A/D257A (PolgA) mice - a mouse model of premature aging, and (iii) our recently established spatial transcriptomics-based "mechanomics" platform which permits gene expression to be analyzed as a function of the local in vivo mechanical environment. Aging impaired the regenerative response in PolgA mice, resulting in an increased occurrence of delayed and non-unions, delayed bone formation / resorption responses, impaired osteogenesis and delayed mineralization of new bone. Cyclic mechanical loading significantly enhanced the regenerative response in young PolgA mice inducing sustained bone formation, suppressing bone resorption, and enhancing mineralization, with the strongest effects observed in peripheral regions of the fracture site. In aged PolgA mice, the mechanosensitivity of the regenerative response was retained with an anabolic response localized to the defect center. Cyclic mechanical loading applied during the reparative and remodelling phases of fracture healing thus represents a potential translational strategy to harness the mechanosensitivity of aged bone.